Complex Regional Pain Syndrome

Reflex Sympathetic Dystrophy

Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy, is a chronic neurological syndrome characterized by a severe burning pain, pathological changes in the skin and bone, excessive sweating, tissue swelling, and extreme sensitivity to touch. There are two types of CRPS, Type I and Type II. CRPS is best described in terms of an injury to a nerve or soft tissue that does not follow the normal healing path and it does not depend on the magnitude of the injury. Physicians can diagnosis this condition with a thorough history and physical exam with the patient, bone scan, sympathetic nervous system tests, x-rays, and an MRI.

Treatment Options

All treatment options are tailored to the patient and the severity of each patient's condition. When treated early, CRPS can respond to a series of nerve blocks performed in the office. If the condition has progressed, a multidisciplinary approach is needed.

  • Physical Therapy is a key aspect to all stages of CRPS. It is important for patients to continue mobilization of the affected extremity to reduce long-term changes such as muscle weakness and decreased blood flow.
  • Another key in the treatment of CRPS, is the management of the patients pain levels. This can be achieved through nerve blocks, electrical stimulation (TENS units), accupuncture and/or spinal cord stimulation. Medication therapy can also be a helpful tool, such as a low dose antidepressant or nonsteroidal anti-inflammatories. Rarely, narcotic management can be used in only select cases.
  • CRPS, at times, can be a very debilitating condition. Because of this, patients can experience depression and other emotional disturbances. Professionals such as therapists or behavioral psychologists help patients to put their pain into perspective and to teach them coping skills and relaxation techniques. Support groups are also available for patients suffering from this condition, where one can share their experiences and feelings with other people.

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